The Relevance of Routine Haemostasis Testing in Children Prior to Adenoidectomy and/or Tonsillectomy
Authors:
A. Samková 1; E. Pařízková 1; P. Ďulíček 2
Authors‘ workplace:
Dětská klinika LF UK a FN, Hradec Králové
přednosta prof. MUDr. M. Bayer, CSc.
1; I. interní klinika – oddělení klinické hematologie LF UK a FN, Hradec Králové
přednosta prof. MUDr. J. Malý, CSc.
2
Published in:
Čes-slov Pediat 2009; 64 (9): 400-405.
Category:
Review
Overview
Adenoidectomy and tonsillectomy are two of the most frequent surgeries in children. In the most of Czech hospitals, screening tests to reveal possible impaired haemostasis and thus bleeding complications are routinely performed before such a surgery.
The benefit of this screening has been however questioned in many studies worldwide. It has been demonstrated that the screening has very low ability to predict the bleeding complications. The reason for those findings is the fact, that most bleeding complications result from local and/or surgical conditions, rather than inherited coagulation disorders. The likelihood to identify a new patient with haemostatic disorder is influenced by the prevalence of clinically significant disorders, which is very low. Moreover, high incidence of falsely positive findings mainly in aPTT in asymptomatic population is causing significant delays in planning of those elective surgical procedures because it often leads to further detailed testing of haemostasis to rule out clinically significant bleeding disorder.
We believe that thorough and careful personal and family history of bleeding tendency/disorder taken with the help of standardized questionnaire is more suitable tool for screening. The indication for laboratory haemostasis testing should be positive personal or family history of a bleeding tendency and/or an absence of a valid history at all.
Key words:
adenoidectomy, tonsillectomy, preoperative haemostasis testing, coagulation, bleeding
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2009 Issue 9
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